A Case of Idiopathic Membranous Nephropathy with Crescents Formation Associated with Anti-GBM Antibody

Korean Journal of Nephrology 2010;29(5):628-633.

Tae Won Kim, M.D.1, Kwan Kyu Park, M.D.2 and In Hee Lee, M.D.1

Departments of Internal Medicine1 and Pathology²
Catholic University of Daegu School of Medicine, Daegu, Korea

증례 : 반월상 형성을 동반한 항사구체기저막항체 양성 원발성 막성 신증 1예

김태원1, 박관규2, 이인희1

대구가톨릭대학교 의과대학 내과학교실1 , 병리학교실2

Abstract

Crescents formation associated with anti-glomerular basement membrane (anti-GBM) antibody is a rare complication in patients with idiopathic membranous nephropathy (MN). Here, we report a 25-year-old male with crescentic MN associated with anti-GBM antibody, who presented with general edema and decreased renal function. Renal biopsy specimen revealed thickening of the glomerular capillary wall consistent with MN. Of 12 glomeruli, three sclerosed, and two crescents formations with interstitial fibrosis were seen. Serology was positive for anti-GBM antibody with titer of 125 enzyme unit (EU)/mL. The patient was treated with pulse intravenous methylprednisolone for 3 days followed by oral prednisolone, and intravenous cyclophosphamide. His renal function was improved significantly 2 weeks after initiation of treatment. In conclusion, crescents formation should be considered in patients with nephritic syndrome accompanied with acute renal dysfunction, and the early biopsy of the kidney and appropriate treatment will be required to improve the clinical outcome.

Key Words: Anti-glomerular basement membrane antibody, Membranous nephropathy, Crescent